Typhlitis in acute childhood leukemia

Abstract

Typhlitis is a necrotizing inflammation of the cecum usually found in acute leukemia patients on chemotherapy in the setting of agranulocytosis. We describe five cases of typhlitis, characterized by fever, abdominal pain, abdominal tenderness and watery diarrhea, occurring during periods of neutropenia. In 4 cases, sonography showed thickening of the cecum wall. Ultrasound appears to offer an easy noninvasive method of diagnosing this potential lethal disease. Four patients were treated successfully with broad-spectrum antibiotics and bowel rest. There was 1 death resulting from septic complication.